ECG interpretation during the acute phase of coronary syndromes: in need of improvement?
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State: Public
Version: Final published version
State: Public
Version: Final published version
Serval ID
serval:BIB_6946FC283E35
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
ECG interpretation during the acute phase of coronary syndromes: in need of improvement?
Journal
Swiss Medical Weekly
ISSN
1424-7860 (Print)
ISSN-L
0036-7672
Publication state
Published
Issued date
2004
Peer-reviewed
Oui
Volume
134
Number
47-48
Pages
695-699
Language
english
Abstract
QUESTION UNDER STUDY: Emergency room (ER) interpretation of the ECG is critical to assessment of patients with acute coronary syndromes (ACS). Our aim was to assess its reliability in our institution, a tertiary teaching hospital. METHODS: Over a 6-month period all consecutive patients admitted for ACS were included in the study. ECG interpretation by emergency physicians (EPs) was recorded on a preformatted sheet and compared with the interpretation of two specialist physicians (SPs). Discrepancies between the 2 specialists were resolved by an ECG specialist. RESULTS: Over the 6-month period, 692 consecutive patients were admitted with suspected ACS. ECG interpretation was available in 641 cases (93%). Concordance between SPs was 87%. Interpretation of normality or abnormality of the ECG was concordant between EPs and SPs in 475 cases (74%, kappa = 0.51). Interpretation of ischaemic modifications was concordant in 69% of cases, and as many ST segment elevations were unrecognised as overdiagnosed (5% each). The same findings occurred for ST segment depressions and negative T waves (12% each). CONCLUSIONS: Interpretation of the ECG recorded during ACS by 2 SPs was discrepant in 13% of cases. Similarly, EP interpretation was discrepant from SP interpretation in 25% of cases, equally distributed between over- and underdiagnosing of ischaemic changes. The clinical implications and impact of medical education on ECG interpretation require further study.
Keywords
Acute Disease, Adult, Aged, Coronary Disease/diagnosis, Coronary Disease/physiopathology, Electrocardiography/methods, Emergency Service, Hospital, Female, Humans, Male, Middle Aged, Syndrome
Pubmed
Web of science
Create date
25/01/2008 14:42
Last modification date
20/08/2019 15:24